In Defense of Demand Feeding

I have had several heartbroken Moms in the last month whose situations have prompted me to write this newsletter. Most have come to me for a lactation or sleep consult around 3 months, exclusively nursing, with a very unhappy baby who is not sleeping.   The baby’s great weight gain is starting to dip on the growth curve, and Mom is exhausting herself trying to make it all work. After asking all my pointed questions, I usually find out one of two things.  Either Mom is following a very strict EAT-PLAY-SLEEP schedule, and limiting feedings to every 3 or 4 hours during the day, or she is limiting the baby’s total intake to 32 ounces daily. 

The first scenario is a very popular child rearing theory popularized by the book BABY WISE.  This book advocates a schedule in which the baby is fed at certain intervals throughout the day, and not sooner, regardless of feeding cues.  In addition, if he happens to be asleep at the designated feeding time, he is woken to feed.  He then plays for a predetermined amount of time, and then is put to sleep, which he often doesn’t want to do, because he is hungry.   While this may work for younger babies, I am paid well for sleep consults around 3 months because suddenly (usually around the growth spurt) this isn’t working and the entire family is miserable.  Unfortunately, BABY WISE, is the beginning of the end of breastfeeding, as limiting feedings limits your supply.  I had two exclusively breastfeeding Moms come to me in this situation at this age this past month.  Despite their best efforts to increase their supply, they weren’t able to.  Both babies now get a significant amount of formula, while still nursing.  Everyone is happier, and the babies are thriving, but it isn’t what either of these women wanted.

The other scenario of limiting babies to 32 ounces daily, regardless of their weight, is out there on the internet. I have also been told that some pediatricians tell their patients this as well.  Confused, as it is contrary to what I have been taught, I finally Googled it myself.   Much to my surprise, I found it on a page about formula feeding on the AAP Healthychildren.org website!  I wrote them last night, let know about my experience with my patients, and asked them to remove it. The page has not been updated since 2009.  On that same page, it states that a baby should have 2-2.5 times their weight in ounces daily.  So a 16 pound baby should have 32-40 ounces daily. And it makes sense if you really think about it.  A baby’s calorie needs grow as he does.  And if you are nursing on demand, your supply will grow with him.

What is a new mother to make of all this easily accessed inaccurate information?  Please remember that if this week is worse than last, and either you or your baby are unhappy, with no one getting sleep, what you are doing isn’t working. It doesn’t matter who told you to do it, even if it was me!  Babies change. Change with them. Trust your instincts.  You know your baby better than anyone. Do what makes sense to you.  Feed your baby when he is hungry.  Let him sleep when he is tired.   Hold him and rock him when he is out of sorts.  Nothing you do today is going to screw him up for the rest of his life.  I promise.

And if you can’t figure it out, please call us.  We are happy to help. Sometimes an objective person assessing the whole situation helps you see what isn’t working.  Often, when you are so tired, you just can’t see it for yourself.  Everyone needs a little help sometimes.  Seek it out.  You and your baby will be glad you did!